Healthcare for Refugees

Asylum seekers and individuals with "Duldung" who have been in Germany for less than 36 months are only entitled to emergency healthcare. 

This means they only receive medical care for acute illnesses or painful conditions. Treatment of chronic illnesses is only covered in certain cases: if they cause acute pain, lead to pain if left untreated, or if treatment is medically necessary. Applications must, in principle, be submitted to the relevant social security authorities.

Exceptions apply to pregnant women and mothers in the first six to eight weeks after birth, who have access to all medical services commonly provided during pregnancy and childbirth in Germany. Preventive medical examinations for children and adolescents are also covered. Furthermore, everyone has the opportunity to get vaccinated. Other services may also be covered in individual cases if they are deemed medically necessary.

If you have been in Germany for less than 36 months, you will usually need to apply for a voucher ("Krankenschein") from the competent authority before each visit to the doctor. This means that you either receive a few vouchers ("Krankenschein") from your initial reception centre (or the staff member responsible for you at the Social Welfare Office) every three months, or each time you need to see a doctor, you must first pick up a voucher ("Krankenschein") from your initial reception centre (or the staff member responsible for you at the Social Welfare Office). 

The authority determines the scope of treatment and, in some cases, may also specify specific service restrictions or specific medical practices.

Please keep in mind that these vouchers ("Krankenschein") are only valid for three months. At the end of these three months, you will have to obtain new vouchers ("Krankenschein") to visit a doctor.

Instead of these vouchers (which can be bureaucratically complicated to issue) some federal states and cities distribute so-called Health Cards for asylum seekers and individuals with a "Duldung" (i.e. "Gesundheitkarten an Asylbewerber un Geduldete"). Holding such a card means you can go directly to the doctor without first stopping by the authorities. But here, too, you are only entitled to emergency treatments. The main advantage of the Health Card is that it decreases the amount of bureaucratic work necessary for all concerned.

You usually can collect the medicines that doctors prescribe for you from any pharmacy. In principle, you do not have to pay for your medications- you just need to hand in your prescription and receive the articles- the pharmacy will be reimbursed by the Social Welfare Office. You can search for a pharmacy nearby on www.aponet.de.

In certain cases, you can also receive physiotherapy or aids such as orthoses. However, you need the approval of the Social Welfare Office for it. 

Even if hospitalisation is necessary, the social welfare office must approve it in advance. However, such an approval is not needed in the case of an emergency.

The asylum seekers and individuals with a tolerated stay ("Duldung") who have been in Germany for more than 36 months or individuals with a so-called “Bestandsschutz” or “Grandfather clause”– are issued a so-called "HealthCard for Refugees" ("Gesundheitskarte für Flüchtlinge") in Germany. With this card, you can directly access medical care without going through the authorities and obtaining vouchers. If you belong to this group, you are entitled to all the regular services of the statutory health insurance, except the long-term care insurance ("Pflegeversicherung"). There are now also statutory co-payments for certain services under the statutory health insurance.

Despite this fact, you are not an official member of statutory health insurance but are only under their supervision and care and the health insurance company is reimbursed by the state for the services they provide you. As an asylum seeker, you are free to choose a statutory health insurance company. Visit handbookgermany.de to learn which statutory health insurance schemes exist and find out more about the benefits and services to which you are entitled. The authorities will complete the registration process for you. 

Please note: The "HealthCard for Refugees" ("Gesundheitskarte für Flüchtlinge") looks just like a normal health insurance card - except for one difference: on the back of a HealthCard for Refugees, the title "European Health Insurance Card" (EHIC) is not specified. The data stored inside this card also differs from the data stored in a regular German insurances card. The HealthCard for Refugees has a specific mark so that the doctor will know the cardholder is not a regular member of the insurance company.

After your arrival in Germany, you will first be accommodated in an initial reception centre ("Erstaufnahmeeinrichtung"). There, in principle, a preliminary medical examination (“Erstuntersuchung”) takes place and acute illnesses are treated immediately. So if you feel unwell, you can talk to a staff member directly. 

Later you can go to any doctor- except for those who only treats private patients. Some doctors only accept patients who are members of private health insurance companies and these patients pay the associated fees directly to the doctor. Since you do not have private insurance, you have to look for doctors who treat people with statutory health insurance (“Kassenpatient*innen”).

You can search for a doctor in your area on the website of the German Medical Association. If you first click on your state and then on "Advanced Search" ("Erweitere Suche"), you can also search for a doctor who speaks your language. If you cannot find a doctor who speaks your language, you will need an interpreter. Ask an employee at your initial accommodation centre or staff at a counselling centre for help if you could not find an interpreter. 

You can find a counseling center nearby using the BAMF navigation system. Enter your postal code or the name of your place of residence. You can also search at proasyl.deor on the website of your local refugee council. You can find the refugee council responsible for you at fluechtlingsrat.de.

There is also a basic medical vocabulary list on the Internet for the first visit, so you can tell the doctor what symptoms you have. Names of different body parts and common diseases are also listed on the same page. There is also a practical questionnaire online with the most important information for your pharmacy visit in several languages ​​(DE/AR; DE/FA; DE/RU).

Asylum seekers and those who have a tolerated stay ("Duldung") can apply to the Social Welfare Office for the costs of their psychiatric therapy to be taken over. If you would like to do so, seek help from a social worker at your accommodation centre or the staff at a counselling centre. 

You can find a counseling center near you using the BAMF navigation system. Enter your postal code or the name of your place of residence. You can also search at proasyl.deor on the website of your local refugee council. You can find the refugee council responsible for you at fluechtlingsrat.de.

The applications which are not rejected immediately will be evaluated and assessed by a doctor appointed by the Social Welfare Office. Keep in mind that these applications are often denied because the authorities do not want to take over the costs of therapies for people with uncertain residence status in Germany. That is why some particular treatment centres offer free psychological care for refugees. But, unfortunately, it is quite difficult to find a free spot in one of these treatment centres because there are too few of them. You can find the addresses and the contact information of these specific centres on the website of the Federal Association of Psychosocial Centers for Refugees and Torture Victims.

Even if you don't have any valid papers, according to the Asylum Seekers Benefits Act, in principle, you are entitled to medical care for acute illnesses. To benefit from this regulation, you have to obtain a voucher ("Krankenschein") from the Social Welfare Office in advance- without such a voucher, the doctor cannot treat you. The Social Welfare Office will then also inform the Immigration Office about your visit.

There are, however, some orgainsations which provide medical service to people who do not have papers anonymously. Their service is free, and the Social Welfare Office or the Immigration Office will not be notified about your visit. On gesundheit-ein-menschenrecht.de, you can find one of these organisation nearby. Furthermore, you can search for anonymous medical assistance nearby on the website of Malteser and the Medibüros.

Please note: Hospitals are not allowed to share your data with other individuals or authorities. So do not hesitate to visit a hospital or call an ambulance in case of an emergency.

In acute medical emergencies, you can call the emergency services at 112 (German). The call is free of charges. You can also go to the emergency reception at any hospital, but keep in mind that you may have to wait for a long time. In case of a mental health emergency, you can also call the emergency services on 112 or contact the nearest psychiatric clinic directly.

If a person shows symptoms of poisoning, you can search for a Poisoning Emergency Centre ("Giftnotrufzentrale") nearby at kindergesundheit-info.de- they are available days and nights.

If you want to buy medicine outside regular opening hours, you will need to go to an emergency pharmacy ("Notapotheke"). On aponet.de, you can search for the nearest emergency pharmacy. You can find more information about emergencies at handbookgermany.de.

People whose asylum application has been rejected as a so-called "Dublin case" and whose deportation to another EU country has been ordered are not entitled to medical benefits by law. This rule, however, is legally controversial. Social courts in Germany have already stopped the withdrawal of benefits for people who have filed an urgent application. It is advisable to seek legal advice. You can find more information on the topic of "Dublin cases" in our chapter "Dublin Procedures."

You can find a counseling center near you on the "Local Search" page or using the BAMF navigation system. Enter the postal code or name of your place of residence. You can also use the services of MBE and JMD. You can also search for a counseling center in your federal state on proasyl.de. A refugee council can also offer support. You can find the refugee council responsible for you at fluechtlingsrat.de.